The client's nursing diagnosis is disturbed sleep pattern related to anxiety. The desired outcome is
that the client will sleep for a minimum of 5 hours nightly by October 31 .
On November 1 sleep data
show the client sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. After the
evaluation, the nurse should
a. leave the care plan unchanged.
b. remove the nursing diagnosis from the care plan.
c. write a new nursing diagnosis that better reflects the problem and its cause.
d. extend the time in which the goal is to be accomplished and examine
interventions.
ANS: D
Sleeping a total of 5 hours at night is still a reasonable outcome. Extending the time frame for
attaining the outcome is appropriate. Examining interventions might result in planning an activity
during the afternoon rather than permitting a nap. Option A is inappropriate. At the very least, the
time in which the outcome is to be attained must be extended. Option B could be used when the
outcome goal has been met and the problem resolved. Option C is inappropriate because no other
nursing diagnosis relates to the problem.
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